Dermatography as a treatment after periocular surgery.

Dermatography is the application of tattooing techniques in medicine. In the past, several techniques have been tried but none of these led to reproducible results. Over the last 17 years, dermatography has been developed into a technique that is both generally applicable and reproducible. It is a suitable treatment modality for disturbing skin discolorations and scars. With dermatography these can be permanently camouflaged. In this paper, the use of dermatography as a treatment after periocular interventions is discussed.

[Keratography (corneal tattooing) in corneal leukoma]. / Keratographie (Hornhauttätowierung) bei Hornhautleukom.

BACKGROUND: Since antiquity attempts have been made to minimize disfigurement and stigmatization of patients with leukoma. Keratography is a relatively new method for imprinting color pigments into the corneal stroma with an entomological needle. MATERIALS AND METHODS: Keratography was performed in 20 patients at the University Eye Hospital, Munich, between November 1997 and September 1999. Patients had either a leukoma that did not tolerate prothesis or had another cloudy corneal disease. The operation was carried out in our outpatient clinic under local anesthesia. RESULTS: There was a single operation in three patients, two operations in nine, three operations in six, and four operations in two. Postoperatively 33% of patients complained of pain. No postoperative bacterial keratitis or perforation occurred. CONCLUSION: All patients were highly satisfied. The long-term stability of color pigments must still be evaluated.

A new treatment for photophobia in posttraumatic aniridia: a case report.

PURPOSE: Using staining pigments with which we had gained experience in dermatography (medical tattooing) treatments of leucoma corneae, a new approach was developed to create an artificial iris-like staining at the mid-stromal level of the cornea to treat photophobia in a patient with posttraumatic aniridia. METHODS: After a central 4-mm half-depth trephination, a lamellar dissection of the corneal stroma toward the limbus was performed. A combination of colored pigments was introduced into this midstromal space, until a light blue artificial iris (to match the contralateral eye) with adequate blocking of light was created. RESULTS: A stable artificial iris was created in the mid-stromal level of the cornea. CONCLUSION: Dermatography pigments are stable in the corneal stroma and are useful to treat photophobia in aniridia following trauma.

Dermatography as a new treatment for alopecia areata of the eyebrows.

BACKGROUND: Alopecia areata is considered to be an autoimmune disease. It consists of patchy hair loss of the scalp and the eyebrows, making it a disfiguring condition. This 10-year study was designed to assess the usefulness of the treatment of the eyebrows with dermatography as a relatively quick and simple method to obtain a cosmetically satisfactory result. MATERIALS AND METHODS: The eyebrow areas were covered with a halftone pattern of tiny dots of color pigments, using a Van der Velden Derma-injector, without anesthesia. On average, two to three dermatography sessions of 1 h were required. The follow-up was 4 years. RESULTS: Thirty three patients, most of whom had been previously treated with a sensitizer such as dinitrochlorobenzene (DNCB), were treated with dermatography. Four patients had also been treated by a beautician with a crude form of tattooing. The results in 30 patients were excellent. In three patients the results were good. CONCLUSIONS: Dermatography is a technique offering a good alternative for time-consuming, troublesome treatment modalities that often have considerable side-effects. With dermatography, no side-effects were found.

Dermatography with bleomycin as a new treatment for verrucae vulgaris.

BACKGROUND: Common warts are caused by infection with human papillomaviruses (HPVs). Many, largely ineffective, treatment modalities have been tried in the past. The cytostatic drug bleomycin has been found to selectively affect squamous cell and reticuloendothelial tissue, but the method of its delivery directly into affected tissue such as warts has been of little efficacy. This study assessed the efficacy of a new mode of intralesional administration of bleomycin by dermatography. METHODS: The warts of patients were treated with increasing concentrations of bleomycin using the van der Velden Derma-Injector, a modified tattooing machine, under local or block anesthesia. The effects of the procedure were evaluated 1, 24, and 48 h later and the patients followed for up to 2 years. RESULTS: Thirteen patients with warts on the hands and/or feet, resistant to conventional therapy, were entered into the study, and two patients dropped out. Of the 11 remaining patients, seven went into full remission that was maintained for at least 2 years. One patient showed moderate progress and in three patients little progress was noted and dermatography was stopped. The dosage of bleomycin varied between 0.1 and 1.0 mg/mL. CONCLUSIONS: Dermatography proved to be an effective technique for intralesional administration of bleomycin in more than two-thirds of patients resistant to conventional therapy. Treatment failures in this study could in part be explained by a defective immune system in the patients. Dermatography is a technique that can be learned by any skillful dermatologist or plastic surgeon.